"Doctor, did you diagnose my mother wrongly? When my mother was having a checkup half a year ago, liver function was normal. How could this turn into advanced liver cancer ?" Mr. Zhang asked in surprise and nervously when he saw his mother's examination report.
"Optical examination of liver function is not enough. Liver function tests may not necessarily detect liver cancer . This condition of your mother is not an isolated case. We now need to formulate relevant treatment plans to help your mother improve the condition." The doctor told Mr. Zhang.
Mr. Zhang thought it was a misdiagnosis before, but after hearing what the doctor said, he could no longer hold his eyes tight and said excitedly: "Doctor, you must save my mother!"
In fact, Mr. Zhang's mother has been suffering from liver cancer for a long time, but liver cancer is a relatively hidden disease. In addition, the compensation function of the liver is too strong, and when they checked liver function , no abnormalities were found, so this did not attract attention.
In fact, clinically, many patients have already entered the advanced stage when they discovered liver cancer . Everyone may be curious and don’t understand why the liver function is checked, but no liver cancer was found.
1. Why is the liver function normal but advanced liver cancer was detected after half a year?
liver is the "chemical factory" of the human body and it is one of the five internal organs. Its color is reddish brown, and it is the largest gland in the body. The normal liver is located in the upper abdomen , the right sea rib , and a few people have livers in the left sea rib . It is attached to diaphragm , adjacent to right lung and heart , below stomach and duodenum and colon , and later also to right kidney and adrenal glands, esophageal cardia .
In the human body, the main functions of the liver are metabolism, deoxidation, storage and regulation of blood, synthesis of secreted proteins, and storing liver sugar , etc. At the same time, the liver also needs to help the digestive system produce bile to promote the digestion and absorption of food.
When there is a problem with the liver, hepatocytes are damaged and liver function will decline. However, the liver is a magical organ because its cell tissue can be regenerated, and it also has the powerful compensated function to maintain normal liver function.
Therefore, when people undergo liver function test , it is difficult to detect abnormal liver function when some liver diseases are not serious. This condition is more common in autoimmune hepatitis , viral hepatitis , alcoholic hepatitis , cirrhosis , and liver cancer early and middle stage .
When these liver diseases occur, the liver function is damaged, and the liver will enter the compensatory period , so that its basic physiological functions can be maintained. If the condition is not discovered in time, the liver cells will be damaged more, and the liver will enter the decompensation period of . At this time, its basic physiological function is difficult to maintain, and the patient will experience obvious discomfort symptoms. Only when he is subjected to liver function examination will heal abnormalities be found.
However, by the time liver decompensation period , most of the disease has developed to a more serious extent. Especially the occurrence of advanced liver cancer will greatly reduce the patient's -year survival rate of . The reason why liver function tests cannot detect early liver cancer is because liver function tests items only include: albumin , bilirubin , alanine aminotransferase , garlic aminotransferase , etc.
In the early stage, liver cancer has less direct impact on these physiological functions. In addition, the liver can compensate for liver function, so draws blood to to check liver function, and abnormalities may not be found, or misdiagnosis may occur, resulting in the development of the disease to the late stage. Therefore, when you are visiting the doctor, in order to more accurately judge the condition, do not just undergo liver function examination.
2. In addition to liver function, two items need to be checked.
From the above, liver function test cannot successfully detect early and middle stage liver cancer . Therefore, after undergoing liver function tests, it is also necessary to combine imaging examinations and with tumor marker screening. These two test results are directly helpful for the diagnosis of liver cancer.
, imaging examination
, so-called imaging examination, mainly uses imaging equipment to perform human imaging, such as X-ray , CT, magnetic resonance, ultrasound, and ECTh, etc. With the development of the times, imaging examination has become one of the important means of diagnosing diseases. If patients with liver disease want to know the liver condition more accurately, they are also necessary to undergo liver imaging examinations.
For example, X-ray barium swallowing test can help patients determine whether chronic liver disease has portal hypertension; B ultrasound can observe changes in the position, size, and nature of the liver, which can be used to diagnose diseases such as intrahepatic stones, intrahepatic calcification, cirrhosis and liver cyst .
In addition, CT scan is very helpful for the diagnosis of liver cancer and fatty liver . CT scan can help patients distinguish the nature of intrahepatic tumors, the specific location of cancer cells, and whether there is any metastasis of . If the CT scan cannot confirm liver cancer, the patient can also use MRI to more accurately determine whether there are cancer cells in the liver.
However, the diagnosis of liver cancer MRI is not absolute. Doctors also need to make a comprehensive judgment based on the examination results of envelope-like enhancement and T2-enhanced imaging medium signal . This will better identify precancerous lesions such as highly dysplastic nodules and formulate treatment plans in a timely manner.
, tumor marker : alpha-fetoprotein screening
After undergoing liver imaging examination, patients still need to do tumor marker screening , that is, alpha-fetoprotein screening .
alpha-fetoprotein is the main component of plasma protein in the embryonic period. It consists of 90 amino acid residues and belongs to one of the proteins. The function of alpha-fetoprotein is to transport fatty acids and to immunosuppress . It can participate in the proliferation and metabolism of cells and combine with fatty acids, estrogen, bilirubin and other substances. In the immune response, alpha-fetoprotein inhibits the maternal immune response to embryonic development and tumor patients.
Under normal circumstances, the human body's alpha-fetoprotein level is between and 25μg/L. If the alpha-fetoprotein is found to increase, you should be wary of primary liver cancer or malignant tumors in the reproductive system. Clinically, patients with primary liver cancer with 0% have increased alpha-fetoprotein, among which 0% examined high concentrations of alpha-fetoprotein in serum.
However, except for liver cancer or reproductive system malignant tumors. Patients with hepatitis and cirrhosis may also experience an increase in alpha-fetoprotein tests, but the increase in alpha-fetoprotein caused by most benign diseases usually does not exceed 00μg/L, and the condition needs to be judged based on imaging and liver function detection.
alpha-fetoprotein is present in serum , so fasting vein blood collection is usually required. The blood collection time is usually early in the morning. The puncture site is disinfected on an empty stomach, and then the peripheral venous blood of ~5ml is removed.
It should be noted that alpha-fetoprotein levels may be affected by diet, so you should pay attention to maintaining a light diet and not drinking alcohol within 112 hours of before the blood test. Fasting for in the first 8 hours of checking , maintain high-quality sleep quality, and do not stay up late, so as not to affect the accuracy of the inspection results.
It can be seen that if you want to diagnose liver cancer , it is not enough to easily check liver function. You must also combine the results of imaging examination and alpha-fetoprotein screening to better judge the condition. At the same time, you should also pay attention to a series of discomfort symptoms that occur in the body.
3. What are the symptoms of liver cancer patients?
According to statistics, in 2020, the new incidence of liver cancer in the world has reached 1.91 million , and the number of deaths is as high as 1.58 million . In the same year, the number of new liver cancer cases in China reached 1.41 million , while the number of deaths has reached 390,000, and the mortality rate has reached 195% or more. In order to avoid further increase in the incidence and mortality of liver cancer, everyone should pay more attention to abnormal manifestations in the body.
For example, in the early stage of liver cancer , more than half of the patients will feel persistent swelling and and dull pain in the liver area. This is because stimulation or pulling of liver envelope during the growth of cancer cells.
In addition, some patients with liver cancer will develop in the early stage and the liver will gradually enlarge , causing uneven surfaces of the liver and nodules of varying sizes. If the condition enters the middle and late stages, the patient will also develop jaundice , and its main symptoms are yellowing of the skin, sclera, and urine.
Not only that, because cirrhosis and progress after worsens, patients will enter the decompensation period of , and increase ascites ligaments in , and bloody ascites invade liver envelope or enter the abdominal cavity, causing more damage to the body.
, etc., until liver cancer spreads and metastasizes, most patients will have systemic reactions, such as progressive weight loss, loss of appetite, fever and fatigue in the body. While cancer cells invade the brain, lungs, lymph nodes, and other parts, it may also cause dizziness, headache, cough , cough sputum, lymph nodes swelling and other symptoms.
The treatment of liver cancer is difficult and has a high degree of malignancy, so everyone should have some understanding of liver cancer . If you find any discomfort symptoms mentioned above, you should go to the hospital in time.
The doctor said that
liver function was normal. After half a year, he was diagnosed with liver cancer and advanced stage. It is very likely that he was not found when he was undergoing liver function examination. Therefore, if you want to know whether the liver is healthy, it is also necessary to check such as imaging examinations and alpha-fetoprotein screening. The condition is also determined through the results of these examinations.
Dear friends, is your liver okay? When checking the liver, it is best not to just do liver function tests! If you still have questions about what I said, you can leave a message below and I can use my professional knowledge to answer it for you.
References
【1】"Structure and Function of Alpha Fetoprotein". Foreign Medicine. Gao Fenghou, Zheng Zuoya. Shanghai.2004-1
【2】"Application Value of Imaging Examination in Diagnosis of Small Liver Cancer". Chinese Journal of Gastroenterology Surgery . Wu Qiuyan; Liu Juan; Yang Chongshuang.2022-04-20
【3】"Clinical Discussion on Serum Alpha Fetoprotein in Testing for Primary Liver Cancer". System Medicine . Wang Wei.2022-02-05
